Karl Gills, of Yampa Valley Medical Center, talks as part of a panel at a forum hosted by The Steamboat Springs Eco­nomic Development Council at The Steamboat Grand. The forum was intended to help local employers unravel potential impacts of the federal health care overhaul that was made law this year.

Health care changes could crowd YVMC in Steamboat

Hospital leader expresses concern about increased demand for services

Ralph Pollock, CEO of the Denver-based international business consulting firm AsiaPacific Access, speaks at a forum hosted by the Steamboat Springs Economic Development Council at The Steamboat Grand. Pollock was part of a panel that also included Lisa Brown, director of development for the Northwest Colorado Visiting Nurse Association; Dr. Brian Harrington, of Yampa Valley Medical Associates; and Karl Gills, of Yampa Valley Medical Center.

Gills, like other health care practitioners in Steamboat and across the country, has wrestled in recent weeks with potential impacts of the wide-ranging health care overhaul made law earlier this year. He said in March that overall, the legislation is “positive” but noted that more people with insurance means more people seeking services — a potentially troubling situation if the number of doctors does not increase, as well. He reiterated that point at a Wednesday health care forum hosted by the Steamboat Springs Economic Development Council at The Steamboat Grand.

The forum was heavy on speculation and light on clear impacts of the legislation for health care providers and businesses, as the overhaul’s regulation and implementation policies are continuing to unfold.

But in raising the specter of a potentially overcrowded YVMC, Gill’s speculation stood out. Routt County has about 4,800 uninsured residents between the ages of 19 and 64, according to the Colorado Health Institute and Lisa Brown, of the Northwest Colorado Visiting Nurse Association. That’s about a third of the county’s population within that age range, Brown said. As many of those people acquire health insurance in coming years through the overhaul’s policies, Gills said, the wait to see a primary care physician could extend throughout several months.

Those patients could instead turn to the YVMC emergency room, he said, which will continue to provide care services. That increased demand comes with a health care overhaul that excludes coverage or payments for undocumented residents and will require other increased costs for the hospital in the short term, Gills said. The fallout means YVMC eventually could have some tough choices as a result of efforts to provide universal coverage and reduced premiums for patients, he said.

“Hospitals may have to pick and choose and not provide services to all payers, to all companies,” Gills said.

Gills said that although in his view, “this bill has a slight positive impact over the long haul” and the hospital is well-positioned to manage its impacts, that view assumes no changes to policies in coming years. The picture could look different in 10 years, he said.

Dr. Brian Harrington, of Yampa Valley Medical Asso­ciates, echoed that uncertainty about how the legislation’s costs could play out.

“Clinics may start to preferentially treat patients who can pay more,” he said. “In my clinical realm, we’re not sure that we’re going to be saving money on this.”

Ralph Pollock was the lead speaker and moderator of Wed­nesday’s event. He’s a founder of Business Health Forum, a Colorado nonprofit organization that helps businesses create sustainable health care plans.

Steve ErkenBrack, of Rocky Mountain Health Plans, was not able to attend Wednesday.

Pollock distributed information about a tax credit that takes effect this year for businesses that have fewer than 25 full-time-equivalent employees and pay average annual wages of less than $50,000 per FTE. Those employers are eligible for the sliding-scale credit if they pay at least 50 percent of the costs for employee health care premiums through a state-licensed company.

The credit can be claimed on 2011 tax returns filed for the 2010 tax year.

Sandy Evans Hall, executive vice president of the Steamboat Springs Chamber Resort Asso­ciation, said the Chamber would do its best to inform local businesses of regulatory policies as they unfold.

“This is something we have to stay on top of as a community,” Evans Hall said.

Comments

Servant-Leadership is what I feel a part of the evolutionary process of best management. I see that many who become great leaders have entered a company in an entry position and then moved up the chain of command. Greenleaf presents clear improvements to the autocratic hierarchal structure by suggesting that the CEO should no longer be at the top of a power pyramid, rather, that the CEO works side by side with other department heads on a more equal power sharing bases as primus inter pares.(Greenleaf p.74) The other main presentation of an improvement in power sharing is the trustees as servants. If I could add another improvement, it would be that the trustees include representatives of the worker groups.

Health care is a prime example of the need to include the patient caregiver in the decision making process of the future of the organization. It is most common for hospital trustees to focus on the need to expand and leave behind a legacy of physical structure at the expense of the patient caregiver. To build requires huge sums of capital that must be extracted from the system, mainly from salaries and benefits. A non-patient caregiver has very little idea of the constant sacrifice required by caregivers: mandatory overtime, working weekends, staying late to cover for emergencies, working nightshifts and holidays. Without proper representation, the worker is rarely considered in the planning and care of an organization. The CEO must carry out the desires of the trustees and will do what the trustees request regardless of the effect it has on the workers.

I believe that it is not only possible, but it is the best solution to create a representative management system as a form of servant leadership. By including the workers, who are the real servants, would improve the concept of participative management by combining the concept with servant leadership.

In a nutshell, it is the worker that does the work that generates revenue and yet he/she is the most ignored contributor in an organization ruled by an autocratic hierarchal management system. If the trustees are wealthy people who have never been in a worker setting or have been away from the worker setting for too long, they may have forgotten what it means to be a servant-leader. Instead, they look at what they can do to leave a "monument" behind in exaltation of their ego rather than listening to their conscience.

Servant Leadership is the best answer to our modern management needs, because it encompasses the human qualities that create the best leader. Empathy and experience go a long way in creating an effective leader.

$6,000,000 surplus last year for this little community is quite a healthy amount to earn from the health care system. Universal government run system is probably the best way to run a fair system for all citizens.
Best reason for universal care is if I get sick because of someone else's fault-pollution, hit by a car,.etc.. why should I be the sole payer????